Organization
TBSG LLC SHC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT J BANCO M.D. (OWNER)
(617) 219-6301
Entity
Organization
Contact information
Practice address
32 NEWTON ST, SOUTHBOROUGH, MA 01772-1215
(508) 481-4700
(508) 481-2150
Mailing address
PO BOX 86, HINGHAM, MA 02043-0086
(781) 749-9071
(781) 749-2133
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
—
—
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
Other
Enumeration date
01/06/2012
Last updated
03/20/2012
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